Glaucoma may not progress in certain people

A small subgroup of Chinese men with suspected or diagnosed glaucoma may not need aggressive treatment, because the condition does not appear to progress, a new study suggests.

In the medical journal Ophthalmology, Dr. Amish Doshi of California's Stanford University and colleagues report on a series of 16 patients originally diagnosed with glaucoma whose condition did not progress over a 7-year period.

More research is needed to better understand how common this type of slow or non-progressing glaucoma is among males of Chinese origin, the researchers say.

In the most common type of glaucoma, open-angle glaucoma, fluid cannot drain properly from the eyeball, leading to increased pressure within the eye and resulting in damage to the optic nerve. It may be treated with medication to lower pressure in the eye, and surgery may be performed to restore normal drainage.

The 16 Chinese glaucoma patients seen by Doshi and colleagues were between 25 and 66 years old. Most of them (81 percent) had some degree of atrophy (wasting) of the optic nerve.

One-quarter had a family history of glaucoma, while many were nearsighted and 31 percent had a visual defect characteristic of glaucoma. Treatment to lower pressure within the eye had been given at least once to more than half of the men and surgery was also being considered for several patients.

But during the seven-year follow-up, none of the patients showed any progression in vision loss or optic nerve damage.

These patients should probably not have been given therapy to lower pressure within the eye, Doshi and his team note. "Surgical therapy, in particular, should be avoided in such individuals."

SOURCE: Ophthalmology, March 2007.